ARTERIOVENOUS OF THE HEAD AND NECK: TREATMENT AND OUTCOME.

Background: Arteriovenous malformations (AVMs) are fast-flow vascular malformations that comprise a complex network of primitive vessels directly connecting feeding arteries to draining veins. AVM is an aggressive disease with a high tendency to recur; its treatment is complex and very challenging, especially in the anatomically delicate head and neck area and requires extensive experience and an interdisciplinary approach. Objectives: This study evaluated the outcome after treatment and analyzed the correlation between the pattern of head and neck AVM and the frequency of recurrence. Materials and Methods: We retrospectively assessed the outcome and recurrence of head and neck AVM after treatment by embolization and resection. Recurrence is defined as expansion following embolization or resection. The effect of sex, age, size, location, stage and treatment modalities on recurrence of head and neck AVM were analyzed. Results: This study includes of 60 patients. All patients were treated by embolization and then resection. Of these, we have follow-up information of at least 6 months after treatment on 55 patients. The outcome was excellent in 73%, good in 20%, fair in 5% and poor in 2% (mean follow-up time, 38.6 months). Of the 55 patients, 14 had recurrences after treatment (long-term recurrence rate, 26%). Recurrence was less likely for lower-staged or small lesions, and did not correlate with age or location. Conclusions: AVM of the head and neck is a one of the most challenging diseases and has a high risk of recurrence. The best chance for long-term control is early and total resection. [ABSTRACT FROM AUTHOR]